【摘要】 目的哮喘和慢性阻塞性肺疾病重叠综合征(ACOS)患者血清维生素D水平改变及其临床意义研究。方法连续性收录22例哮喘患者、32例COPD患者和26例ACOS患者,综合分析比较三组患者肺功能情况和血清维生素D水平差异。结果哮喘组和ACOS组患者吸入支气管舒张剂后FEV1改善值明显高于COPD组(P<0.05)。COPD组和ACOS组患者FEV1%pred水平均明显低于哮喘组(P<0.05)。COPD患者血清25(OH)D3水平明显低于哮喘组和ACOS组患者,而哮喘组明显高于ACOS组(P<0.05)。三组患者血清维生素D水平均与吸烟指数呈负相关(哮喘组:r=-0.582,P=0.029;COPD组:r=-0.601,P=0.022;ACOS:r=-0.687,P=0.015)。而ACOS组患者可见血清维生素D水平与FEV1改善值(r=0.620,P=0.032)和FEV1%pred(r=0.489,P=0.037)呈正相关。血清维生素D水平用以诊断ACOS的AUC为0.643,95%CI为0.523-0.678。结论 ACOS患者中血清维生素D水平低于哮喘患者,而高于COPD患者,且与肺功能具有一定的相关性。更多还原

【Abstract】 Objective To investigate the change and clinical significance of serum vitamin D level patients with asthma-chronic obstructive pulmonary disease(COPD)overlap syndrome(ACOS).Methods Consecutive 22 cases of asthma,32 cases of COPD and 26 cases of ACOS were enrolled in this study.The pulmonary function situation and difference of serum vitamin D levels were compared and analyzed among these three groups.Results The FEV1 improvement value after inhaling bronchodilators in the asthma group and ACOS group was significantly higher than that in the COPD group(0.46±0.14 L,0.37±0.08 Lvs.0.23±0.08 L,P<0.05).The FEV1%pred level in the COPD and ACOS group was significantly lower than that in the asthma group(P<0.05).The serum 25(OH)D3level in the COPD group was significantly lower than that in the asthma group and ACOS group,while the asthma group was significantly higher than the ACOS group(P<0.05).The serum vitamin D level in these three groups was negatively correlated with the smoking index(asthma group:r=-0.582,P=0.029;COPD group:r=-0.601,P=0.022;ACOS group:r=-0.687,P=0.015).The serum vitamin D level in the ACOS group was positively correlated with the FEV1 improvement value and FEV1%pred(r=0.620,P=0.032;r=0.489,P=0.037).The area under the roc curve(AUC)of serum vitamin D level for diagnosing ACOS was 0.643(95%CI 0.523-0.678).Conclusion The serum vitamin D level in ACOS patients is lower than that in asthmatic patients,but higher than that in COPD patients,moreover which has a certain correlation with pulmonary function.更多还原